Health Insurance From a Gen Z Perspective

Let’s get something straight; being an adult is TERRIFYING!

If you don’t think that’s the case, then you’ve been one for too long. The transition from teenager to adult is one of those things that nobody really prepares you for. First, you’re 18 years old and still raising your hand to go to the bathroom, and then all of sudden you’re expected to know how to do your taxes, schedule your own appointments, pay rent on time and the big one—know how health insurance works.

Health insurance has got to be one of the most confusing things to understand. It’s hard to ask questions about because most of the time you don’t know what you don’t know. You hear things like, “high deductibles,” “low premiums” and “copayments;” meanwhile, all you can think is…. huh? Well, I’m here to say that’s okay. I went from knowing nothing about health insurance to knowing a bit more than the average joe, thanks to my internship at HATCX.

Below are the five most surprising things I learned about health care over the past few months.

1. Doctors don’t know how much your visit is going to cost.

Doctors are treating you as a patient—not as an insured individual. They’ll refer you to specialists they trust or send you to get a procedure in a location that’s familiar to them. While they have your insurance information, and will try to remain in-network, they don’t know how much your final bill is going to be or if there is a cheaper alternative. That’s why it’s important to shop around before making a decision (when possible). Speaking of how much you pay…

2. Different providers will charge you different rates for the same procedure – even if they’re all in your network!

You could get an MRI for $200, but depending on where you go, that same MRI could cost you $450, even when you’re going to an in-network provider. No, the more expensive MRI doesn’t come with a complimentary meal, and it isn’t done with a fancier machine; it’s all dependent upon the contracted deal that providers have made with your health insurance. For this reason, it’s wise to use a cost transparency tool to find the best price.

3. You’re allowed to ask questions (or go somewhere else).

You’re the one who is in charge of your health care. If your doctor refers you somewhere you aren’t comfortable, or you found a less expensive option, you’re allowed to speak up and ask questions. Your doctor will likely be more than willing to listen to you and work with you to provide the best experience possible. Don’t be afraid to come in with a plan and follow through.

4. You’ve met your deductible…but wait, there’s more!

Health care is expensive! Monthly, you’ve got your premium to pay—that’s what gives you coverage. Then you have to pay your deductible (a set amount for the insurance year). And even when you’re finished paying that, you still are still responsible for paying coinsurance, or a percentage of your medical services. This can all add up to a pretty penny, but luckily there is an out-of-pocket maximum that the government has put in place. For self-coverage that limit is $7,350 and for family coverage that limit is $14,700.

5. Wait for the EOB.

This is another thing that goes against everything you’re taught. However, it’s important that you pay your doctor bill after it’s been processed by your insurance company (you’ll know because you’ll receive an EOB). This way, you don’t end up overpaying, or paying twice. For more information on what the heck an EOB is, check out this fun post.

So, while I can’t make being an adult any less terrifying, hopefully I’ve given you a few insights into your health insurance. I leave you with this; may there always be enough avocado for your toast, may your phone calls never be awkward, and may your health insurance never surprise you.